ObjectiveTo review current evidence on left colic artery (LCA) preservation during radical rectal-cancer surgery, covering anatomic rationale, surgical techniques, oncologic safety and functional outcomes.MethodsPubMed, Embase, the Cochrane Library and CNKI were comprehensively searched for randomized trials, cohort studies and meta-analyses published in the past two decades that compared high-tie inferior mesenteric artery (IMA) ligation with low-tie LCA-preserving procedures. Key end-points included overall survival (OS), disease-free survival (DFS), local recurrence, anastomotic leak, urogenital and bowel function, and peri-operative recovery.ResultsAcross the aggregated literature, five-year OS, DFS, local-recurrence rates and R0 resection rates did not differ significantly between the two ligation strategies. Preserving the LCA consistently reduced clinical anastomotic leaks and was associated with better postoperative urinary, sexual and bowel function, as well as marginally shorter hospital stay and time to gastrointestinal recovery. Pre-operative CTA or MRA accurately delineates IMA-LCA branching patterns and collateral integrity, while intra-operative indocyanine-green fluorescence provides real-time perfusion assessment; emerging artificial-intelligence models show promise in refining both pre-operative planning and intra-operative decision-making.ConclusionsWhen meticulous D3 lymph-node clearance is maintained, LCA preservation delivers oncologic outcomes equivalent to high-tie ligation while offering notable advantages in peri-operative safety and long-term function. Consequently, low-tie LCA-preserving resection should be considered the preferred approach for most low-anterior resections unless specific anatomic or oncologic contraindications exist. Future multicentre randomised trials and AI-assisted studies are warranted to identify high-risk subgroups and optimise patient-specific indications.

This mini-review aims to examine how molecular PET and immuno-PET may complement tissue-based biomarkers in gastric cancer immunotherapy by enabling whole-body assessment of target expression, stromal biology, immune effector activity, and treatment-related inflammatory changes. Gastric cancer remains a major global health burden, while immunotherapy is expanding from advanced disease into perioperative and conversion settings. However, clinical benefit remains heterogeneous, and conventional biomarkers such as PD-L1, HER2, and MSI/dMMR do not fully capture spatial and temporal variation across lesions. Molecular PET broadly encompasses tracers targeting metabolism, receptors, stromal components, and immune biology, whereas immuno-PET uses radiolabeled antibodies or related scaffold proteins to visualize target distribution and, in some settings, pharmacodynamic changes in vivo. Current evidence in gastric cancer suggests potential roles for HER2-targeted PET, FAPI PET, and granzyme B PET in lesion characterization, stromal phenotyping, early response assessment, and prognostic stratification. However, PD-L1 imaging in gastric cancer remains supported mainly by preclinical data, and much of the checkpoint-imaging literature is extrapolated from non-gastric malignancies. Major barriers include limited gastric-cancer-specific prospective cohorts, heterogeneous tracer formats and imaging time points, lack of standardized quantitative thresholds, and a shortage of outcome-driven studies. Overall, molecular PET and immuno-PET should currently be viewed as promising translational tools rather than routine clinical biomarkers, with their greatest near-term value likely lying in multimodal patient stratification and early pharmacodynamic assessment.

Surgical site infection (SSI) remains a major postoperative complication despite advances in perioperative prophylaxis and standardized care. Increasing evidence suggests that perioperative malnutrition is a host-related condition linking systemic inflammation, impaired immune recovery, low muscle mass, delayed wound healing, and increased susceptibility to infection. This narrative review summarizes the biological relationship between perioperative malnutrition and SSI, critically compares the roles of GLIM, PG-SGA, PNI, CONUT, and GNRI, and distinguishes SSI-specific findings from evidence based on broader postoperative outcomes. GLIM and PG-SGA are most useful for defining clinically meaningful malnutrition phenotypes, whereas PNI, CONUT, and GNRI support rapid and objective risk quantification. Because these tools capture different dimensions of nutritional vulnerability, we propose a complementary, stepwise pathway integrating early screening, phenotype-based diagnosis, secondary risk stratification, targeted intervention, and postoperative reassessment. This framework should be regarded as a hypothesis-generating clinical model that requires prospective validation before it can be adopted as a standardized SSI-prevention algorithm.

目的:分析胆囊结石患者行微创保胆取石术后结石复发的情况及影响因素,评估保胆取石术的可行性.方法:收集2019年12月—2021年10月在我院接受保胆手术治疗的患者171例,进行为期1年的术后随访,分成13例复发组,158例未复发组.比较两组的性别、年龄、家族史、高血压、糖尿病、体质量指数(BMI)、结石数量、胆囊壁毛糙、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)及服用中药情况,采用多因素Logistic回归分析结石复发的相关因素.结果:患者术后1年复发率为7.6％(13/171).两组结石数量、胆囊壁毛糙、TG、HDL-C、家族史、服用中药差异有统计学意义(P＜0.05).多因素Logistic回归分析显示:胆囊结石数量＞1 个(OR=11.585,95％CI=1.578～85.030,P=0.016)、TG水平高(OR=4.139,95％CI=1.402～12.220,P=0.010)、有胆囊结石家族史(OR=8.785,95％CI=1.238-62.345,P=0.030)是保胆术后结石复发的独立危险因素,服用中药(OR=0.059,95％CI=0.008-0.433,P=0.005)可以降低术后结石的复发率.结论:对于有强烈保胆意愿的患者,行保胆取石术是有效的,但有一定的复发风险,保胆取石术胆囊结石数量多、TG水平高、有家族史是保胆取石术后结石复发的独立危险因素,服用排石汤可降低复发风险,具有风险因素的患者应谨慎行保胆取石术,或术后针对危险因素进行预防性治疗.

根据国际恶性肿瘤研究机构统计全球每年新增确诊恶性肿瘤中胃恶性肿瘤占5.6％,位于第5位.胃恶性肿瘤的发病率在世界范围内存在显著差异[1].在过去20年中,在胃恶性肿瘤(GS)的治疗方法上有了显著的进步.对局部晚期疾病患者使用新辅助疗法,以及外科技术的不断发展和标准化,均有效改善患者的预后.但胃恶性肿瘤患者的长期生存率仍远低于其他恶性肿瘤[2].造成这些不良结果的原因无疑是多因素的,与其他肿瘤部位相比,胃恶性肿瘤患者存在局部晚期病灶或远处转移的概率更高.此外,手术切除在技术上具有挑战性,术后病死率仍然较高[3].在胃恶性肿瘤中,恶病质可能是影响术前评估、术后恢复以及非治愈性治疗方法疗效的一个关键因素.本文对恶病质病理生理学和胃恶性肿瘤治疗的相关性综述如下.

Background:Early noninvasive screening of patients who would benefit from neoadjuvant chemotherapy (NCT) is essential for personalized treatment of locally advanced gastric cancer (LAGC). The aim of this study was to identify radio-clinical signatures from pretreatment oversampled computed tomography (CT) images to predict the response to NCT and prognosis of LAGC patients. Methods:LAGC patients were retrospectively recruited from six hospitals from January 2008 to December 2021. An SE-ResNet50-based chemotherapy response prediction system was developed from pretreatment CT images preprocessed with an imaging oversampling method (i.e. DeepSMOTE). Then, the deep learning (DL) signature and clinic-based features were fed into the deep learning radio-clinical signature (DLCS). The predictive performance of the model was evaluated based on discrimination, calibration, and clinical usefulness. An additional model was built to predict overall survival (OS) and explore the survival benefit of the proposed DL signature and clinicopathological characteristics. Results:A total of 1060 LAGC patients were recruited from six hospitals; the training cohort (TC) and internal validation cohort (IVC) patients were randomly selected from center I. An external validation cohort (EVC) of 265 patients from five other centers was also included. The DLCS exhibited excellent performance in predicting the response to NCT in the IVC [area under the curve (AUC), 0.86] and EVC (AUC, 0.82), with good calibration in all cohorts (P>0.05). Moreover, the DLCS model outperformed the clinical model (P<0.05). Additionally, we found that the DL signature could serve as an independent factor for prognosis [hazard ratio (HR), 0.828, P=0.004]. The concordance index (C-index), integrated area under the time-dependent ROC curve (iAUC), and integrated Brier score (IBS) for the OS model were 0.64, 1.24, and 0.71 in the test set. Conclusion:The authors proposed a DLCS model that combined imaging features with clinical risk factors to accurately predict tumor response and identify the risk of OS in LAGC patients prior to NCT, which can then be used to guide personalized treatment plans with the help of computerized tumor-level characterization.

Background Situs inversus totalis (SIT) is a rare congenital disease with a series of clinical features characterized by a mirror image distribution of the viscera to the normal anatomy. Case presentation This study aims to report a 63-year-old male SIT patient with gastric cancer with a preoperative diagnosis of stage IIB gastric cancer (cT3N0M0), who underwent a preoperative multi-disciplinary treatment (MDT) discussion and an abdominal enhancement CT for visceral evaluation to ensure a successful operation. A laparoscopic-assisted distal gastrectomy including D2 lymph node dissection and Billroth I reconstruction was successfully performed. Laparoscopic radical gastric gastrectomy and D2 lymph node dissection were performed through the opposite surgical station to the conventional one, followed by digestive tract reconstruction under small incision-assisted direct vision. There was less blood loss throughout the operation, no postoperative complications, and the patient was discharged successfully 10 days after surgery. Histopathological examination showed ulcerated high-medium differentiated adenocarcinoma stage IB (PT2N0M0). There were no complications or tumor recurrence in the patient with examination 6 months after the operation. Conclusion Surgery in a patient with gastric cancer and SIT can be safely performed by the application of 3D laparoscopy and small incisions to assist the digestive tract reconstruction under direct vision.

IntroductionMalignant melanoma with gastric metastasis is extremely rare. We report a case of gastric metastasis caused by malignant melanoma of the lower limb.Case presentationA 60-year-old woman was hospitalized for left plantar pain. The patient found a black maculopapular eruption on the left sole of her left foot, which caused pain when pressed, and the pain was aggravated by walking, so she went to our hospital for treatment. On the second day of admission, the lesion of the left foot was removed under local anesthesia, and the removed tissue was sent for pathological examination. Combined with immunohistochemistry, it was consistent with malignant melanoma. During hospitalization, the patient developed abdominal pain and asked for gastroscopy. Gastroscopy revealed two 0.5 cm × 0.6 cm spots that can be seen arising from the stomach mucosa which were slightly swollen, slightly black in the center, and without erosion, and no abnormality was found in the other parts. At the same time, a biopsy was taken under a gastroscope and pathology suggests malignant melanoma. The patient could not undergo subsequent treatment due to cost. The patient was followed up until February 2022 and was within the survival period.ConclusionMalignant melanoma gastric metastasis is extremely rare. When a patient has a previous history of melanoma surgery, this needs to be considered when gastrointestinal symptoms are present, and regular endoscopic screening is recommended. Early surgical treatment and postoperative chemotherapy or combined targeted therapy may improve the prognosis of patients.

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Journal of Surgical OncologyEarly View LETTER TO THE EDITOR Association between enrollment in an enhanced recovery program for colorectal cancer surgery and long-term recurrence and survival Ling Jin MD, Ling Jin MD Department of Pharmacy, Tongde Hospital of Zhejiang Province, Hangzhou, ChinaSearch for more papers by this authorQiang Hu MD, Corresponding Author Qiang Hu MD 15700190534@163.com orcid.org/0000-0002-6964-0220 Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China Correspondence Qiang Hu, MD, Department of General Surgery, Tongde Hospital of Zhejiang Province, 234 Gu Cui Rd, Hangzhou 310012, China. Email: 15700190534@163.comSearch for more papers by this authorYuanshui Sun MD, Yuanshui Sun MD orcid.org/0000-0003-1237-9938 Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, ChinaSearch for more papers by this author Ling Jin MD, Ling Jin MD Department of Pharmacy, Tongde Hospital of Zhejiang Province, Hangzhou, ChinaSearch for more papers by this authorQiang Hu MD, Corresponding Author Qiang Hu MD 15700190534@163.com orcid.org/0000-0002-6964-0220 Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China Correspondence Qiang Hu, MD, Department of General Surgery, Tongde Hospital of Zhejiang Province, 234 Gu Cui Rd, Hangzhou 310012, China. Email: 15700190534@163.comSearch for more papers by this authorYuanshui Sun MD, Yuanshui Sun MD orcid.org/0000-0003-1237-9938 Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, ChinaSearch for more papers by this author First published: 07 June 2022 https://doi.org/10.1002/jso.26886Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

Journal of Surgical OncologyVolume 125, Issue 2 p. 301-305 LETTER TO THE EDITOR Comment on “Comparison of open and minimally invasive approaches to colon cancer resection in compliance with 12 regional lymph node harvest quality measure” Qiang Hu MD, Qiang Hu MD orcid.org/0000-0002-6964-0220 Department of general surgery, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, ChinaSearch for more papers by this authorYuan Shui Sun MD, Yuan Shui Sun MD orcid.org/0000-0003-1237-9938 Department of general surgery, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, ChinaSearch for more papers by this authorXi Yin Yang MD, Corresponding Author Xi Yin Yang MD sissyyxy@163.com Department of Traditional Chinese Medicine, Community Health Service Center of Guali Town of Xiaoshan, Hangzhou, Zhejiang, China Correspondence Xi Yin Yang, Department of Traditional Chinese Medicine, Community Health Service Center of Guali Town of Xiaoshan, 180 Guayu RD, Hangzhou, 311241 Zhejiang, China. Email: sissyyxy@163.comSearch for more papers by this author Qiang Hu MD, Qiang Hu MD orcid.org/0000-0002-6964-0220 Department of general surgery, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, ChinaSearch for more papers by this authorYuan Shui Sun MD, Yuan Shui Sun MD orcid.org/0000-0003-1237-9938 Department of general surgery, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, ChinaSearch for more papers by this authorXi Yin Yang MD, Corresponding Author Xi Yin Yang MD sissyyxy@163.com Department of Traditional Chinese Medicine, Community Health Service Center of Guali Town of Xiaoshan, Hangzhou, Zhejiang, China Correspondence Xi Yin Yang, Department of Traditional Chinese Medicine, Community Health Service Center of Guali Town of Xiaoshan, 180 Guayu RD, Hangzhou, 311241 Zhejiang, China. Email: sissyyxy@163.comSearch for more papers by this author First published: 17 November 2021 https://doi.org/10.1002/jso.26580Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume125, Issue2February 2022Pages 301-305 RelatedInformation

Introduction: Left-sided appendicitis is a rare condition, and we report a patient with left abdominal heterotopia of the right colon complicated by acute appendicitis in the left lower quadrant. Case presentation: A 39-year-old male was admitted to hospital following left lower abdominal pain for 1 day. Imaging examination by abdominal CT showed that the appendix was not clearly seen, and a mass was found in the left lower abdomen. Because the patient's abdominal pain was severe and the current diagnosis was not clear, after soliciting the patient's consent, we performed laparoscopic exploration. This exploration revealed that the cecum and ascending colon were located in the left iliac fossa, the appendix was swollen, the length of the appendix was approximately 6 cm, the diameter of the appendix was approximately 1 cm, and there was pus moss attached to the surface. We performed a laparoscopic appendectomy; the procedure was uneventful and the patient was discharged 3 days after the procedure. Conclusion: Left-sided appendicitis is a rare condition and is therefore easy to misdiagnose. Wrong diagnosis can lead to serious complications and endanger the patient's life. Therefore, a full combination of laboratory tests and CT scan is required. If still no diagnosis can be made correctly, a laparoscopic exploration needs to be performed in a timely manner. This case teaches us that when we encounter a patient with severe left abdominal pain that cannot be definitely diagnosed, we need to be vigilant and perform timely laparoscopic exploration when necessary.

Journal of Surgical OncologyEarly View LETTER TO THE EDITOR Aerobic fitness and muscle density play a vital role in postoperative complications in colorectal cancer surgery Piaopiao Chen MD, Piaopiao Chen MD Graduate School, Zhejiang Chinese Medical University, Hangzhou, ChinaSearch for more papers by this authorQiang Hu MD, Corresponding Author Qiang Hu MD 15700190534@163.com orcid.org/0000-0002-6964-0220 Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China Correspondence Qiang Hu, Department of General Surgery, Tongde Hospital of Zhejiang Province, 234 Gucui Rd, Hangzhou 310012, China. Email: 15700190534@163.comSearch for more papers by this authorYuanshui Sun MD, Yuanshui Sun MD orcid.org/0000-0003-1237-9938 Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, ChinaSearch for more papers by this author Piaopiao Chen MD, Piaopiao Chen MD Graduate School, Zhejiang Chinese Medical University, Hangzhou, ChinaSearch for more papers by this authorQiang Hu MD, Corresponding Author Qiang Hu MD 15700190534@163.com orcid.org/0000-0002-6964-0220 Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China Correspondence Qiang Hu, Department of General Surgery, Tongde Hospital of Zhejiang Province, 234 Gucui Rd, Hangzhou 310012, China. Email: 15700190534@163.comSearch for more papers by this authorYuanshui Sun MD, Yuanshui Sun MD orcid.org/0000-0003-1237-9938 Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, ChinaSearch for more papers by this author First published: 30 March 2022 https://doi.org/10.1002/jso.26849Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

Introduction Small bowel obstruction is a common surgical emergency abdominal condition in clinical practice. Fecalith is one of the rare causative factors, especially phytobezoars. Case Report We report the case of a 66-year-old man admitted with “abdominal pain with vomiting for 1 day.” Enhanced CT of the abdomen suggested incomplete small bowel obstruction. The symptomatic treatment with fasting, fluid replacement, gastrointestinal decompression, and antibiotics was conducted after the patient was admitted to the hospital. After 2 days of treatment, the patient's abdominal pain was not significantly relieved, so a decision was made to perform laparoscopic examination surgery. During surgery, a columnar foreign body was found embedded in the lumen of the small intestine about 10 cm away from the ileocecal region. Combined with the patient's preoperative history of consuming a large number of persimmons, the primary diagnosis of small intestinal fecalith obstruction was considered. We performed an enterotomy to remove the foreign body, and the procedure was uneventful. On postoperative day 7, the patient was successfully discharged. Conclusion When we encounter a patient with intestinal obstruction without a history of surgery in our clinical work, we should take a careful history, especially about the consumption of foods that can cause phytoliths. When a patient has consumed a large amount of food that can cause phytobezoars before the abdominal pain, we should diagnostically consider it as phytobezoars intestinal obstruction, which helps to reduce the incidence of misdiagnosis and allows the patient to receive treatment timely and effectively.

Journal of Surgical OncologyVolume 125, Issue 8 p. 1332-1332 LETTER TO THE EDITOR Evaluating the longitudinal effect of colorectal surgery on health-related quality of life in patients with colorectal cancer Qiang Hu MD, Qiang Hu MD orcid.org/0000-0002-6964-0220 Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, ChinaSearch for more papers by this authorYuanshui Sun MD, Yuanshui Sun MD orcid.org/0000-0003-1237-9938 Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, ChinaSearch for more papers by this authorXiyin Yang MD, Corresponding Author Xiyin Yang MD sissyyxy@163.com Department of Traditional Chinese Medicine, Community Health Service Center of Guali Town of Xiaoshan, Hangzhou, China Correspondence Xiyin Yang, MD, Department of Traditional Chinese Medicine, Community Health Service Center of Guali Town of Xiaoshan, 180 Guayu RD, Hangzhou 311241, China. Email: sissyyxy@163.comSearch for more papers by this author Qiang Hu MD, Qiang Hu MD orcid.org/0000-0002-6964-0220 Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, ChinaSearch for more papers by this authorYuanshui Sun MD, Yuanshui Sun MD orcid.org/0000-0003-1237-9938 Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, ChinaSearch for more papers by this authorXiyin Yang MD, Corresponding Author Xiyin Yang MD sissyyxy@163.com Department of Traditional Chinese Medicine, Community Health Service Center of Guali Town of Xiaoshan, Hangzhou, China Correspondence Xiyin Yang, MD, Department of Traditional Chinese Medicine, Community Health Service Center of Guali Town of Xiaoshan, 180 Guayu RD, Hangzhou 311241, China. Email: sissyyxy@163.comSearch for more papers by this author First published: 30 March 2022 https://doi.org/10.1002/jso.26837Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume125, Issue8June 15, 2022Pages 1332-1332 RelatedInformation

To the Editor, We have read with interest the article published by Liu et al. Parastomal hernia will bring a heavy burden to patients physically and psychologically. Therefore, correctly understanding the risk factors related to the occurrence of parastomal hernia has important clinical significance. Although we believe it is a fascinating topic, we would like to offer the following points for your consideration. First, in Table 1, the stoma diameters of the two groups are not given. Because of the fear of stoma necrosis or stenosis, most doctors have made the stoma diameter very large in clinical practice, and more and more studies have shown that the stoma diameter is too large is the risk factor of inducing parastomal hernia. The research of de Ruiter et al. used the principles of physics to incisively explain the mechanical relationship between the size of stoma diameter and the formation of parastomal hernia. They believe that the abdominal stoma is affected by two forces, the tangential force parallel to the stoma (Ftang) and the radial force perpendicular to the stoma (Frad), in which Ftang is the main force causing parastomal hernia. According to Laplace's law, Frad = P × R/2(P is abdominal pressure, R is the abdominal radius), Ftang = Frad × R = P × R × r/2 (r is stoma radius).

IntroductionAdult intussusception is a rare disease that is difficult to diagnose and treat and is even rarer when it is caused by a lipoma of the small intestine. We reported a case of a small intestine lipoma combined with intussusception, which can guide people in future clinical work.Case PresentationA 51-year-old female was admitted to the hospital with “abdominal pain for 1 month.” Enhanced computed tomography (CT) of the abdomen suggested a lipoma in the left lower quadrant and a proximal intussusception. After excluding surgical contraindications, laparoscopic exploration was performed on the second day of admission, which showed a small amount of ascites in the abdominal cavity, a small intestine–small intestine-type intussusception about 20 cm from the ileocecal area and about 140 cm from the ileocecal area, and a mass of about 2×4 cm that was palpable by laparoscopic intestinal forceps, which was protruded into the intestinal cavity with a soft texture and sound mobility. A 5 cm-long incision was made above the mass to dissect into the abdomen layer by layer, and the diseased intestine was dislodged outside the abdominal cavity with oval forceps. The intestine was reduced by hand and observed for half an hour after reduction, and the blood circulation and peristalsis of the intestine were observed to be still sound. The intestine was dissected at 2 cm from the upper and lower margins of the mass using linear anastomosis to operate small intestine side-to-side anastomosis. The intestine was opened concurrently and closed with a linear anastomosis, using 3-0 absorbable thread to reinforce anastomosis intermittently. The procedure went smoothly, and the patient was discharged on the 5th postoperative day.ConclusionA small intestinal lipoma combined with small intestinal intussusception is rare in clinical practice and needs to be diagnosed by asking history detailedly, physical examination, and relevant ancillary tests such as abdominal CT. Laparoscopic-assisted small incision surgery for adult intussusception combines the advantages of laparoscopic surgery and laparotomy, operating simply and easily.